Provider Demographics
NPI:1093555047
Name:DEEPALI TUKAYE
Entity type:Organization
Organization Name:DEEPALI TUKAYE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TUKAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-961-4914
Mailing Address - Street 1:1411 PALMETTO DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2555 GULF FWY S STE 500
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6742
Practice Address - Country:US
Practice Address - Phone:832-400-2777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty